scholarly journals A Case of Intraductal Papillary Neoplasm with an Associated Invasive Carcinoma

2017 ◽  
Vol 78 (12) ◽  
pp. 2729-2735
Author(s):  
Tomohiro OOKURA ◽  
Takefumi NIGUMA ◽  
Toru KOJIMA ◽  
Nobuyuki WATANABE ◽  
Tetsushige MIMURA
2017 ◽  
Vol 102 (1-2) ◽  
pp. 70-76
Author(s):  
Ryo Ashida ◽  
Teiichi Sugiura ◽  
Yukiyasu Okamura ◽  
Takaaki Ito ◽  
Keiko Sasaki ◽  
...  

Although there have been many previous studies of IgG4-related SC focusing on the differential diagnosis from cholangiocarcinoma, only a few patients with cholangiocarcinoma against a background of IgG4-related SC have been reported. We herein present a case of intraductal papillary neoplasm of the bile duct (IPNB) associated with invasive carcinoma complicating IgG4-related sclerosing cholangitis. A 71-year-old female with icterus was admitted to a local hospital, where stricture of the extrahepatic bile duct were detected, and subsequently referred to our hospital for possible surgery. Abdominal multidetector-row computed tomography demonstrated marked wall thickening along the entire extrahepatic bile duct. The left lateral superior bile duct (B2) and left lateral inferior duct (B3) were individually obstructed, and percutaneous transhepatic biliary drainage catheters were placed in B2 and B3 separately. The patient was diagnosed to have diffusely spread cholangiocarcinoma and underwent right hepatic trisectionectomy with caudate lobectomy and pancreatoduodenectomy. A histological examination revealed intraductal papillary tumors composed of fibrovascular stalks covered by neoplastic epithelium. Carcinomatous invasion of the papillary tumors was observed in the fibromuscular layer, and there was abundant infiltration of inflammatory cells with fibrosis outside of the cancerous tissue. The inflammatory cells were primarily composed of plasma cells, a majority of which were positive for IgG4 (>30 cells/high-power field); the postoperative serum IgG4 level was 890 mg/dL. Therefore, a diagnosis of coexisting IPNB associated with invasive carcinoma and IgG4-related sclerosing cholangitis was made. To the best of our knowledge, this is the first report of IPNB complicating IgG4-related sclerosing cholangitis.


2022 ◽  
Vol 15 (1) ◽  
pp. e245918
Author(s):  
Tetsuro Takasaki ◽  
Takashi Sakamoto ◽  
Akira Saito ◽  
Yasuaki Motomura

An 82-year-old man presented to the emergency department with abdominal pain and febrile symptoms that had been present for 4 days. Blood tests showed elevated liver enzymes and white blood cell count, and abdominal contrast-enhanced CT revealed a 35 mm cystic lesion in the left lateral liver lobe. On closer examination, the cystic lesion was found to have contiguous bile duct dilatation and internal nodules. Furthermore, mucus production was observed during endoscopic retrograde cholangiopancreatography, which led to the diagnosis of intraductal papillary neoplasm of the bile duct (IPNB), with cystic infection. Although the patient was an older adult, there was no background disease that would have prevented surgery, and resection was performed. Pathological examination revealed type 1 IPNB, with invasive carcinoma. The number of reports of IPNB is expected to increase with an increasing older population in Asia, and we report the findings of this case.


2019 ◽  
Vol 70 (4) ◽  
pp. 692-699 ◽  
Author(s):  
Sunyoung Lee ◽  
Myeong-Jin Kim ◽  
Sohee Kim ◽  
Dongil Choi ◽  
Kee-Taek Jang ◽  
...  

2021 ◽  
Author(s):  
Eisuke Mukaida ◽  
Akio Tamura ◽  
Kunihiro Yoshioka ◽  
Masao Nishiya ◽  
Tamotsu Sugai

In this report, we present a 57-year-old female with a history of mild alcoholic liver disease during a medical check-up. Abdominal computed tomography and magnetic resonance imaging showed a multicystic mass with a solid enhancing mural nodule in the right lobe of the liver. Subsequently, laparoscopic right liver lobectomy was performed and pathological findings revealed intraductal papillary neoplasm of the bile duct (IPNB) with an associated invasive carcinoma. IPNB is a relatively rare disease that should be considered in the differential diagnosis of hepatic cystic tumours. Our case report highlights the importance of capturing image findings of the IPNB as this disease has a high potential for malignancy.


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